For many, the struggles associated with aging are an inevitable part of life. Similarly, watching loved ones grow old can includes transitioning into the role of caretaker and taking on new responsibilities. Sometimes, part of this journey can include navigating the trials of Alzheimer’s — an incurable disease that tends to worsen over time. The stress that this disease puts on patients and their families has researchers searching for novel treatments. Inspired by psychedelics’ success in treating other neurological disorders, the medical community is beginning to explore the potentials of psychedelics as a treatment for Alzheimer’s.
What is Alzheimer’s?
Alzheimer’s disease is a neurological disorder that damages the brain’s cognitive and memory abilities. Over time, Alzheimer’s progressively affects more and more of a person’s functioning. A feature of Alzheimer’s disease is the presence of dementia. Dementia is a general term for loss of cognitive functioning to the extent that daily activities are affected. People’s range of functioning varies based on their dementia severity. Though Alzheimer’s is not the only cause of dementia, it is the most common — affecting roughly 6 million Americans alone.
Alzheimer’s can begin affecting the brain a decade before cognitive or behavioral symptoms present themselves. This is because Alzheimer’s disease produces an excess of protein deposits — specifically, amyloid proteins and tangles of neurofibrillary proteins. Amyloid proteins are abnormal proteins originating in the bone marrow that cause buildup on organs. In Alzheimer’s patients, the amyloid deposits clump between neurons, stopping their ability to communicate with each other. The neurofibrillary tangles hijack neuron’s production of tau proteins, causing these proteins to stick together in dense tangles rather than attaching to the structural microtubules within the cell. The tangles disrupt the cell from within, hindering neural transport to and from the synapse.
The specific structural brain changes associated with Alzheimer’s disease are thought to exist because of the unique interplay of these two proteins. The clumps of abnormal amyloid proteins bunch into the synaptic space of neurons in areas of the brain associated with memory. There appears to be a tipping point, where enough blocked synapses trigger rapid production of tau protein tangles within the cells. Eventually, by working together these proteins cause the neuron to die off. Enough dead neurons in one area and the region is unable to function and shrinks.
Brains affected by Alzheimer’s are also unable to execute proper cleaning procedures. The brain has specific glial cells, responsible for clearing out debris and pruning off protein deposits. Researchers are unsure why or how Alzheimer’s hinders the glial cells from performing their cleaning duties, but the result is further neural damage as the glial cells build-up and release inflammatory chemicals. The protein build-ups also affect blood flow to the brain, giving Alzheimer’s patients higher chances for stroke and increased neural death.
The first area of the brain affected by Alzheimer’s is the hippocampus —the seahorse-shaped tube responsible for memory and learning — and the nearby entorhinal cortex — part of the temporal lobe responsible for navigation and perception of time. The initial damage to these areas presents as symptoms of memory loss and confusion characteristic of early-stage Alzheimer’s.
Alzheimer’s disease affects patients differently and changes over time as more areas of the brain atrophy. Usually, people present with Alzheimer’s in their mid-60’s though early-onset cases make up about 10% of diagnoses. Early and mild stages can involve loss of word-finding abilities and general confusion, while more moderate stages often involve delusions and paranoia.
For caregivers and loved ones, Alzheimer’s can be incredibly challenging to manage as the person suffering loses their ability to relate to the world around them. Doctors are desperate for revolutionary treatment approaches, but let’s take a look at what is available now.
Current Treatment Available
The current treatment approaches aim to help people with Alzheimer’s maintain cognition, behavioral function and hopefully slow down memory loss. The hope is to find treatments addressing the root causes of the disease but at the moment there are no preventative solutions.
FDA approved pharmaceutical medications work to treat Alzheimer’s in two ways: Cholinesterase inhibition and glutamate signaling.
Cholinesterase inhibitors, like Donepizel or Exelon, are commonly prescribed for moderate or mild Alzheimer’s cases. One of the ways that this disease harm’s the brain is by decreasing the production of acetylcholine, a key neurotransmitter for alertness, memory and judgment. By blocking the production of cholinesterase, a protein that breaks down acetylcholine, the medications try to keep acetylcholine available in the synapse. This does not stop the progression of Alzheimer’s, as over time the neurons are unable to produce enough acetylcholine for the medication to be of help.
For late-stage Alzheimer’s, medications containing Memantine, work to balance levels of glutamate in the brain. Glutamate is an important excitatory neurotransmitter, the key to opening many different metabolic pathways in the brain. In Alzheimer’s patients, the glutamate system can be overactive, causing toxicity that damages the brain. However, glutamate is still an essential part of learning and memory so the hope is that by balancing the brain’s glutamate levels, Alzheimer’s patients can retain cognitive function.
Both of these medication options have modest effects at best, making the demand for new Alzheimer’s treatments incredibly high. As researchers work to tackle the many different mechanisms by which Alzheimer’s damages the brain, psychedelics begin to present as a viable treatment option.
Psychedelics as Treatment
The schedule one listing of most psychedelic substances at the beginning of the 1970s halted the exploration of psychedelics as treatments for decades. As the culture shifts, respected institutions realize that the legalization of psychedelics may have been more politically motivated than associated with potential risks related to these substances.
Researchers at Johns Hopkins University, believe that psychedelics have the ability to change not only brain function but structure. The human brain comprises more than 10 billion neurons. Psychedelics pose the potential to change how the branches of these neurons structure areas of the brain, promoting adaptive neuroplasticity. Apart from structural change, psychedelics can also influence the way different parts of the brain communicate with each other.
Inspired by these findings and the success of psilocybin in animal trials aiming to improve memory processes, Johns Hopkins researchers are currently conducting a clinical trial of psilocybin treatments for early-stage Alzheimer’s. Their plan — put on hold for a year due to the global pandemic — is to administer 2 large doses of psilocybin to around 20 participants with no placebo. The goal is to look for changes in mood and memory over the following months.
Researchers in the UK identified the commonalities between the success of psychedelic treatments for neurological disorders like depression and its promise as an Alzheimer’s treatment. Psychedelics like psilocybin and LSD have the potential to stimulate neurogenesis, promote neuroplastic change and reduce inflammation. These are all helpful tools in combating the degeneration associated with Alzheimer’s disease.
Aside from treating the disease, many Alzheimer’s patients suffer from depression and anxiety. Not only does this affect their quality of life, but some studies show that both of those cognitive patterns can adversely affect memory down the line. Psychedelics’ ability to treat depression and anxiety may be able to help improve the quality of life and memory retention of Alzheimer’s patients.
There are currently no definitive answers about psychedelics’ ability to treat Alzheimer’s but researchers are hopeful for answers in the next few years as clinical trials conclude. The demand for new and innovative treatments continues to grow as new generations of people experience the loss of Alzheimer’s. The willingness to see psychedelics as a solution can bring new hope to families around the world.
Alzheimer’s can be a sensitive topic for many people, if you feel comfortable we would love to hear your thoughts in the comments below.
